TMS Effects on Pain Perception

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DESCRIPTION (provided by applicant): The purpose of this K23 is to provide support for the candidate to acquire the skills necessary to conduct patient-oriented research on novel treatments for pain and co-morbid psychiatric disorders. Chronic pain represents a huge public health concern and is generally poorly understood at a basic neurobiological level. There is a lack of individuals with adequate training in the neurobiology of pain who also have the skills to perform high quality clinical evaluations of new treatments. The candidate wishes support for training to become a clinical translational scientist with specific expertise in evaluating novel treatments that will serve as the foundation for his career as a leader in the development and evaluation of new somatic or device-based treatments for chronic pain. The candidate will become familiar with new treatments such as transcranial magnetic stimulation (TMS), vagus nerve stimulation, and deep brain stimulation. The training aspects of the Award will focus on increasing the candidate's knowledge regarding functional neuroanatomy, empirical and theoretical mechanisms of pain, and technology-based treatments. Building on this foundation, the research project will focus on investigating the effects of TMS on pain perception. Previous research suggests that TMS may reduce pain in healthy adults and clinical samples. However, there is relatively little systematic research on TMS and pain that addresses optimal TMS device parameters, optimal cortical targets, and potential differences in response to TMS between healthy subjects and chronic pain populations. The Specific Aims of the research project are to: 1) Test for replication, findings that stimulation of the motor cortex with TMS results in changes in pain perception and investigate the duration of analgesic effect; 2) Determine the TMS device parameters that are associated with the largest changes in acute pain perception to controlled laboratory pain stimuli; 3) Determine which TMS cortical targets are associated with the largest changes in pain perception; and 4) Determine if findings from the laboratory investigations generalize to patients with trigeminal neuralgia. Building on the candidate's knowledge base in clinical psychology, statistics, psychophysiology and computer programming, the proposed training program and research project will help the candidate develop into an innovative and critical expert in developing and evaluating new treatments for pain.